Vascular surgery competitiveness

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CaliDoc89

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Hey All, I've been seriously considering vascular surgery residency, but I can't find any reliable resources online about how competitive vascular surgery really is. All I've heard is that there are 6+ applicants per every position. There are several sites with the current 0+5 and 3+3 programs, but none of these mention average step 1, AOA, publications, etc...
Does anyone know of any sites with vascular residency match data or anything else that may be of interest to me? thanks in advance peeps! 😀

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Hey All, I've been seriously considering vascular surgery residency, but I can't find any reliable resources online about how competitive vascular surgery really is. All I've heard is that there are 6+ applicants per every position. There are several sites with the current 0+5 and 3+3 programs, but none of these mention average step 1, AOA, publications, etc...
Does anyone know of any sites with vascular residency match data or anything else that may be of interest to me? thanks in advance peeps! 😀

Think of it as a very minor step below plastics.

In fact, imagine you're applying to plastics and you'll have the proper mentality for competitiveness.
 
Think of it as a very minor step below plastics.

In fact, imagine you're applying to plastics and you'll have the proper mentality for competitiveness.

I don't necessarily agree with the statement. Integrated vascular surgery is very competitive in that there are so few spots available (I believe it was 46 this year?). But, if you look at the individual stats, they are not always that impressive. I know of two people with Step I scores in 220-240s and no AOA and they ended up matching at some of the top programs in Northeast. But they had good research/publications, so that might be why. Also, connection plays a huge role in this field, and if your school has a vascular residency or fellowship program, that helps a big time in your favor.
 
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I just read a few AAMC reports on the most competitive specialties. Vascular was in there. The list had maybe 10 or so entries.

"The list of most competitive specialties resembled last year's, with dermatology, orthopaedic surgery, otolaryngology, radiation oncology, thoracic surgery, and vascular surgery filling 90 percent of positions with U.S. seniors."

https://www.aamc.org/students/medst...sletter/spring12/278772/2012_match_recap.html
 
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I don't necessarily agree with the statement. Integrated vascular surgery is very competitive in that there are so few spots available (I believe it was 46 this year?). But, if you look at the individual stats, they are not always that impressive. I know of two people with Step I scores in 220-240s and no AOA and they ended up matching at some of the top programs in Northeast. But they had good research/publications, so that might be why. Also, connection plays a huge role in this field, and if your school has a vascular residency or fellowship program, that helps a big time in your favor.

This is literally the exact same description as plastics differing only in # of spots.
 
This is the only data publicly available.

http://www.vascularweb.org/APDVS/Do...eting Presentations/9 Makaroun APDVS 2012.pdf

Makaroun is the program director for Pitt, arguably one of the powerhouse programs and one of the few programs with two integrated vascular residents per year. The Pitt data is good for a couple of reasons. First, of the 27 people they interviewed last year, 25 went on to match in Vascular. Given that we only had 41 spots total last year, I think that their interview pool pretty accurately represents the people who matched Vascular. I know the two people who interviewed and didn't match Vascular. Their Step 1 scores were 245 and 248. Both matched competitive general surgery positions. Average Step 1 score was 236 and Step 2 was 244.

Based on our program, we have two spots, we interviewed 15 from an applicant pool of 150+. Total applicant pool across the country was estimated to be about 300. (this year, unlike the data in Makaroun's ppt which is last year.

Take from those numbers what you will, but I think an argument can be made for Vascular and Thoracic surgery to be as competitive as virtually anything else out there, largely on virtue of the small number of spots.
 
I don't necessarily agree with the statement. Integrated vascular surgery is very competitive in that there are so few spots available (I believe it was 46 this year?). But, if you look at the individual stats, they are not always that impressive. I know of two people with Step I scores in 220-240s and no AOA and they ended up matching at some of the top programs in Northeast. But they had good research/publications, so that might be why. Also, connection plays a huge role in this field, and if your school has a vascular residency or fellowship program, that helps a big time in your favor.

1) Do you know what the top programs are in the Northeast? Big name medical school != top residency program (for any specialty)
2) There are plenty of people in the <240 Step 1 range who match into every specialty.
3) More people with no AOA match Plastics than people with AOA.
4) Connections matter in every specialty when it comes to the top programs. Every little edge helps when it comes to only a handful of spots. This is no different in Plastics, Ortho, Thoracic etc.
5) Your school having a strong vascular residency or fellowship does not help you get into programs. The issue is that people who aren't exposed to vascular early don't apply to the integrated programs. This is why there are a disproportionate number of residents who are from medical schools associated with the powerhouse vascular programs. Again, no different than any other specialty.
 
1) Do you know what the top programs are in the Northeast? Big name medical school != top residency program (for any specialty)
2) There are plenty of people in the <240 Step 1 range who match into every specialty.
3) More people with no AOA match Plastics than people with AOA.
4) Connections matter in every specialty when it comes to the top programs. Every little edge helps when it comes to only a handful of spots. This is no different in Plastics, Ortho, Thoracic etc.
5) Your school having a strong vascular residency or fellowship does not help you get into programs. The issue is that people who aren't exposed to vascular early don't apply to the integrated programs. This is why there are a disproportionate number of residents who are from medical schools associated with the powerhouse vascular programs. Again, no different than any other specialty.

Actually one of the two people I mentioned ended up matching at Pitt. I do appreciate Pitt's data btw, but it still doesn't change my stance. I don't doubt the competitiveness of the specialty, and yes there are only 40 something spots available. But, the stats of applicants in vascular don't come close to those of people going into plastic. I had a chance to look at Pitt's applicant data, and looks like the avg Step I score is 236, which is surprisingly marginal and even lower than ENT or Derm. It wouldn't be right to extrapolate the overall competitiveness of the specialty solely based on this number, but it's still a useful indicator. Don't get me wrong: vascular is indeed very competitive, but just not to the same degree as plastic. That's all.
 
Don't get me wrong: vascular is indeed very competitive, but just not to the same degree as plastic. That's all.

From what I know, smaller fields like vascular surgery and thoracic surgery require the student to have shown a significant interest in research and have good connections. Both of these are more important than any one USMLE score (obviously though the student can't be dumb...). The reason research and connections are the most important factors is because these fields were traditionally general surgery fellowships, and if a program is going to take a pgy-1 they don't want that person to find out in 2 or 3 years that he/she actually doesn't like that particular brand of surgery and then leave. There are few spots and it would be a shame to waste it on a person who will not complete the training and contribute to the field.
 
Actually one of the two people I mentioned ended up matching at Pitt. I do appreciate Pitt's data btw, but it still doesn't change my stance. I don't doubt the competitiveness of the specialty, and yes there are only 40 something spots available. But, the stats of applicants in vascular don't come close to those of people going into plastic. I had a chance to look at Pitt's applicant data, and looks like the avg Step I score is 236, which is surprisingly marginal and even lower than ENT or Derm. It wouldn't be right to extrapolate the overall competitiveness of the specialty solely based on this number, but it's still a useful indicator. Don't get me wrong: vascular is indeed very competitive, but just not to the same degree as plastic. That's all.

He just said that two people that were rejected had Step scores of 245 and 248, so clearly, as you said, you shouldn't use Step 1 scores to determine absolute competitiveness at these programs. There's obviously more to the applicant than that, or those individuals would have matched.

You're saying that it's not as competitive as plastics because the field has lower step scores, on average. I think that's a terrible fallacy of logic.
 
He just said that two people that were rejected had Step scores of 245 and 248, so clearly, as you said, you shouldn't use Step 1 scores to determine absolute competitiveness at these programs. There's obviously more to the applicant than that, or those individuals would have matched.

You're saying that it's not as competitive as plastics because the field has lower step scores, on average. I think that's a terrible fallacy of logic.

+1 Isn't the definition of competitive related to how many people apply versus how many slots there are? If 90 people apply for 90 positions and those 90 people have an avg step score of 260, that doesn't necessarily make the specialty competitive.
 
+1 Isn't the definition of competitive related to how many people apply versus how many slots there are? If 90 people apply for 90 positions and those 90 people have an avg step score of 260, that doesn't necessarily make the specialty competitive.

To some degree, although self selection muddies the waters.

If a specialty has traditionally been unkind to people with Step I scores <240 (or <230, or whatever number you want to pick), people may choose not to attempt to match into that specialty with scores that do not meet that cutoff.

Additionally, there are "unwritten" requirements for some specialties, such as research (many subspecialty fields are terribly difficult to match into without some research background). Other factors like AOA status can be hugely influential as well; in fields like Derm, Plastics, and ENT, almost half of (or more than half of, in the case of Derm) successful matches are AOA. The specialties considered most competitive are typically the ones for which you really need to have it all: grades, board scores, research, AOA, LORs, etc.

People on SDN like to talk about how, say, EM is becoming "really competitive", based largely on the fact that it, you know, tends to fill 100% before SOAP, and people fail to match into it. So,[and I am prepared to be flamed by people here] even though as a middle-of-the-road EM applicant in 4th year you might think "boy this might be tough to match into), how "competitive" was it to get to that middle-of-the-road EM applicant status in the first place? Not easy, surely, as medical school is never easy; but it's not the same as someone who has set themselves up as a stellar (or even middle of the road) Plastics candidate.

What it really comes down to is that when you speak of "competitiveness" of a specialty, you can consider it two ways.

1. How difficult it is to match into the specialty as a 4th year student applying "against" all the other applicants in that specialty
2. How difficult it is to match into the specialty from day 1 of medical school.

This is not to suggest that everyone who does not go into Derm/Plastics/whatever chose to "settle" for other specialties (and indeed, many people have no interest whatsoever in the more competitive fields), but it's very difficult to parse out everyone's initial goals and compare them with the ultimate results.

Think of it as an intention-to-treat analysis (a weak but somewhat applicable analogy). If you ignore all the people who entered medical school but then never considered applying to [insert super competitive field of choice] due to perceived difficulty in doing so, it may change the interpretation of the data.
 
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+1 Isn't the definition of competitive related to how many people apply versus how many slots there are? If 90 people apply for 90 positions and those 90 people have an avg step score of 260, that doesn't necessarily make the specialty competitive.

Well that's assuming that every position is the same and the goal is just to get in. But you will be competing for something, whether it's the prestige, location or something else. The level of competition is based more on the quality of applicants as opposed to the quantity.
 
To some degree, although self selection muddies the waters.

If a specialty has traditionally been unkind to people with Step I scores <240 (or <230, or whatever number you want to pick), people may choose not to attempt to match into that specialty with scores that do not meet that cutoff.

Additionally, there are "unwritten" requirements for some specialties, such as research (many subspecialty fields are terribly difficult to match into without some research background). Other factors like AOA status can be hugely influential as well; in fields like Derm, Plastics, and ENT, almost half of (or more than half of, in the case of Derm) successful matches are AOA. The specialties considered most competitive are typically the ones for which you really need to have it all: grades, board scores, research, AOA, LORs, etc.

People on SDN like to talk about how, say, EM is becoming "really competitive", based largely on the fact that it, you know, tends to fill 100% before SOAP, and people fail to match into it. So,[and I am prepared to be flamed by people here] even though as a middle-of-the-road EM applicant in 4th year you might think "boy this might be tough to match into), how "competitive" was it to get to that middle-of-the-road EM applicant status in the first place? Not easy, surely, as medical school is never easy; but it's not the same as someone who has set themselves up as a stellar (or even middle of the road) Plastics candidate.

What it really comes down to is that when you speak of "competitiveness" of a specialty, you can consider it two ways.

1. How difficult it is to match into the specialty as a 4th year student applying "against" all the other applicants in that specialty
2. How difficult it is to match into the specialty from day 1 of medical school.

This is not to suggest that everyone who does not go into Derm/Plastics/whatever chose to "settle" for other specialties (and indeed, many people have no interest whatsoever in the more competitive fields), but it's very difficult to parse out everyone's initial goals and compare them with the ultimate results.

Think of it as an intention-to-treat analysis (a weak but somewhat applicable analogy). If you ignore all the people who entered medical school but then never considered applying to [insert super competitive field of choice] due to perceived difficulty in doing so, it may change the interpretation of the data.

Lol. Not sure why EM had such a target on their backs these days. I know that medicine loves prestige or status (be it name dropping Harvard, AOA, 260+, whatever that says you're better) and I realize EM isn't prestigious, bit that doesn't explain why people take shots at EM.

Funny because I've never heard people say EM is competitive like plastics or vascular surgery. I've heard people say EM is more competitive than EM used to be, but that's it. Curious if anyone can find a post where someone days EM is more competitve than any surgical sub, derm or whatever is in that top tier.

I'm not Flaming you. People have all but called EM doctors triage nurses, and your pinion is your own. Just not sure why people are calling out EM. I don't see FM or really any other doctors who are constantly attacked.
 
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Lol. Not sure why EM had such a target on their backs these days. I know that medicine loves prestige or status (be it name dropping Harvard, AOA, 260+, whatever that says you're better) and I realize EM isn't prestigious, bit that doesn't explain why people take shots at EM.

Funny because I've never heard people say EM is competitive like plastics or vascular surgery. I've heard people say EM is more competitive than EM used to be, but that's it. Curious if anyone can find a post where someone days EM is more competitve than any surgical sub, derm or whatever is in that top tier.


Nobody (including me) has suggested it's been said by others that EM is more competitive than the other subspecialties mentioned.
 
Nobody (including me) has suggested it's been said by others that EM is more competitive than the other subspecialties mentioned.

So what is wrong with EM applicants dating EM is more competitve than it used to be? I think it's true.
 
Lol. Not sure why EM had such a target on their backs these days. I know that medicine loves prestige or status (be it name dropping Harvard, AOA, 260+, whatever that says you're better) and I realize EM isn't prestigious, bit that doesn't explain why people take shots at EM.

Funny because I've never heard people say EM is competitive like plastics or vascular surgery. I've heard people say EM is more competitive than EM used to be, but that's it. Curious if anyone can find a post where someone days EM is more competitve than any surgical sub, derm or whatever is in that top tier.

I'm not Flaming you. People have all but called EM doctors triage nurses, and your pinion is your own. Just not sure why people are calling out EM. I don't see FM or really any other doctors who are constantly attacked.

I remember a thread in which one poster made the argument that EM had become more competitive than rads because rads has had more slots open for SOAP/Scramble the last few years. It did not go well for him/her. It's a pretty basic error of logic.

There is actually a thread in Pre-Allo right now talking about the reasons why EM gets dumped on by a lot of people.
 
Don't forget - there's always the much easier approach of doing 5 years of general surgery and then going into vascular surgery.

I think integrated vascular is competitive because you don't have the 5 years of general surgery to completely turn you off to doing vascular 😛 There is absolutely nothing I hate more than being on call and hearing there's a consult for a cold leg in the ED.
 
Don't forget - there's always the much easier approach of doing 5 years of general surgery and then going into vascular surgery.

I think integrated vascular is competitive because you don't have the 5 years of general surgery to completely turn you off to doing vascular 😛 There is absolutely nothing I hate more than being on call and hearing there's a consult for a cold leg in the ED.

How much "easier" is it to go the old 5+3 route? What factors come into play when you apply for a fellowship out of general surgery? Is it more reliant on research/recommendations and stuff rather than test scores?
 
Don't forget - there's always the much easier approach of doing 5 years of general surgery and then going into vascular surgery.

I think integrated vascular is competitive because you don't have the 5 years of general surgery to completely turn you off to doing vascular 😛 There is absolutely nothing I hate more than being on call and hearing there's a consult for a cold leg in the ED.

I don't know if vascular is going this way too, but in plastics they're phasing out the fellowships and opening up more integrated spots. Which makes a lot of sense - whats the point of doing 5 years of general surgery if you're not going to use the vast majority of that experience ever again in practice?
 
How much "easier" is it to go the old 5+3 route? What factors come into play when you apply for a fellowship out of general surgery? Is it more reliant on research/recommendations and stuff rather than test scores?
It's 5+2, and it's much easier. I won't pretend to know a whole lot, because I am staying far away from the field, but I hear that it's not competitive for a general surgery graduate.

I don't know if vascular is going this way too, but in plastics they're phasing out the fellowships and opening up more integrated spots. Which makes a lot of sense - whats the point of doing 5 years of general surgery if you're not going to use the vast majority of that experience ever again in practice?
Integrated vascular is still in the experimental phase, basically. I doubt a single vascular fellowship has had to close because of the integrated programs, yet.
 
Is the 0+5 really a good program? I feel like every vascular surgeon has always been a general AND vascular surgeon. I wonder how feasible a 100% vascular surgery practice would be in private practice. I'm sure in certain markets it is possible. I have the same reservations about a 100% VIR practice, most interventional radiologists also do diagnostics on the side in private practice. 100% practices do exists (obviously in academic environments) in a few private settings, but it is not the norm.

Just food for thought.
 
It's 5+2, and it's much easier. I won't pretend to know a whole lot, because I am staying far away from the field, but I hear that it's not competitive for a general surgery graduate.


Integrated vascular is still in the experimental phase, basically. I doubt a single vascular fellowship has had to close because of the integrated programs, yet.

Mine closed the fellowship. As did at least a couple others.
 
Well, yes, presumably you wouldn't have two different pathways to the same destination. I meant unaffiliated programs.

But this would mean that if you do a GS residency, vascular fellowships will become more competitive as more and more fellowships are turned into integrated vascular programs.

Unless there are newish (within past 2-3 years) vascular surgery fellowships opening up to counteract the transition from fellowships to integrated residency.
 
I apologize for bringing back an old thread but, I was looking at the 2014 charting outcomes for vascular surgery and they don't seem to line up with some of the stats posted in this thread (granted this thread was made a year before the 2014 charting outcomes). According to the data published by the NRMP, there were 51 integrated positions offered and 42 of these filled. 89% of US applicants matched and there were 9 unfilled positions in the match. The average step 1 was a 237. According to these stats, the integrated vascular match is only slightly more competitive than the GS match and no where near as competitive as plastics/derm/ENT/Uro etc... Is this correct or am I misinterpreting the data?
 
As I have long said, the integrated vascular and i6 CT residents are basically on par with the more-competitive general surgery applicants.

Where the two groups differ is that the vascular and cardiac applicants tend to have better research CVs and have demonstrated longer interest in the field - this is important as there are a small number of spots, and attrition is a huge problem for these programs (if you only take 1 resident per year, and your resident quits because they realize they didn't like it, you've got a big problem). So the PDs really value letters and research.

I think the publicly available data is somewhat superficial, but I've seen a lot of applications to both fields.

That being said, it seems like many people are matching into some of the low to mid tier integrated vascular programs with little to no research. With 9 spots going unfilled it seems that if you really want a spot and are willing to go anywhere, you will get a spot. Is this a fair assessment or am I way off?
 
That being said, it seems like many people are matching into some of the low to mid tier integrated vascular programs with little to no research. With 9 spots going unfilled it seems that if you really want a spot and are willing to go anywhere, you will get a spot. Is this a fair assessment or am I way off?

Like SS says - a lot of programs are more than willing to go unmatched and go through the soap rather than taking a poor fit. There are a ton of great applicants in the soap from the unmatched ent/ortho/plastics/uro crew, many of whom would be fine doing vascular.
 
This is n=2 but two students in the past MS4 class at my school matched this past cycle. Both of them reported step scores between 230-235 on our "post match survey" emails.
 
That being said, it seems like many people are matching into some of the low to mid tier integrated vascular programs with little to no research. With 9 spots going unfilled it seems that if you really want a spot and are willing to go anywhere, you will get a spot. Is this a fair assessment or am I way off?

Like SS says - a lot of programs are more than willing to go unmatched and go through the soap rather than taking a poor fit. There are a ton of great applicants in the soap from the unmatched ent/ortho/plastics/uro crew, many of whom would be fine doing vascular.

This is n=2 but two students in the past MS4 class at my school matched this past cycle. Both of them reported step scores between 230-235 on our "post match survey" emails.

Programs in general would rather not match than match a bad candidate. From what I have seen, programs are actually less interested in the unmatched ENT/Ortho etc. and more interested in the superstar IMGs that hammer Cardiac and Vascular hard. Program directors seem less than thrilled to take on less than enthusiastic ENT/Ortho etc hopefuls. Part of it is fear that they may still try to jump ship in a year or two and the other part is that from a fit perspective, they don't really overlap a ton.
 
Okay,
The stats are wrong. There were only two unfilled spots post-match/SOAP for vascular integrated. So, those numbers are bull****
 
Programs in general would rather not match than match a bad candidate. From what I have seen, programs are actually less interested in the unmatched ENT/Ortho etc. and more interested in the superstar IMGs that hammer Cardiac and Vascular hard. Program directors seem less than thrilled to take on less than enthusiastic ENT/Ortho etc hopefuls. Part of it is fear that they may still try to jump ship in a year or two and the other part is that from a fit perspective, they don't really overlap a ton.
Yup,
That's what they do. Also include sniping other residents in different specialties at their programs (which I don't fault at all)
 
Programs in general would rather not match than match a bad candidate. From what I have seen, programs are actually less interested in the unmatched ENT/Ortho etc. and more interested in the superstar IMGs that hammer Cardiac and Vascular hard. Program directors seem less than thrilled to take on less than enthusiastic ENT/Ortho etc hopefuls. Part of it is fear that they may still try to jump ship in a year or two and the other part is that from a fit perspective, they don't really overlap a ton.

I can see that line of reasoning, there's probably a lot of truth to it - I'd doubt their dedication to vascular too. Are the superstar IMGs going unmatched during the initial match, though?
 
I can see that line of reasoning, there's probably a lot of truth to it - I'd doubt their dedication to vascular too. Are the superstar IMGs going unmatched during the initial match, though?

Yes. Many aren't even in the match, they are playing research assistant in departments across the country or overseas. There are the same problems that you would have with any IMG, can they speak English? Do they understand how to function in an American hospital? Can they master American norms and customs? But, there are a lot of very dedicated CV/Vascular oriented IMGs out there, for some reason overseas CV is still hot compared to within the US. You can see it reflected in the charting the outcomes too, they disproportionately apply IVS.
 
Also not sure where you are getting that 9 spots went unfilled. In 2014 3 spots went unfilled and this year 2 spots went unfilled per this: http://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf (Table 18)

Not sure why the number of positions offered in the SOAP don't match the number of positions that went unmatched. My guess would be that some of those 9 unmatched positions were filled outside of the SOAP or the programs withdrew the positions.
 
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